Articles: pain-management.
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Clinical Trial
Does autonomic neuropathy influence spinal cord stimulation therapy success in diabetic patients with critical lower limb ischemia?
Spinal cord stimulation (SCS) improves microcirculatory blood flow and relieves diabetic neuropathic and ischemic pain, reducing the amputation rate in patients with peripheral arterial occlusive disease (PAOD). The purpose of this study was to evaluate whether the presence of autonomic neuropathy in diabetic patients with PAOD influences the success of SCS therapy. ⋯ Diabetic patients with peripheral arterial occlusive disease presenting with intractable pain may be successfully treated with spinal cord stimulation unless they have associated severe autonomic neuropathy.
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Pain is a prevalent symptom in cancer patients, affecting up to 50% of patients undergoing active cancer treatment and up to 90% of those with advanced disease. Although adequate relief can be achieved in the majority of cancer patients, pain is often treated inadequately in traditional settings and sometimes even under the management of more specialised units. ⋯ This is in keeping with increasing recognition by bodies such as the World Health Organisation and other governmental agencies who have recognised the importance of pain management as part of routine cancer care. Conducting a comprehensive assessment, competently providing analgesic drugs, and communicating with the patient and family allow effective management of pain in the cancer patient.
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The practice guidelines for interventional techniques in the management of chronic pain are systematically developed statements to assist practitioner and patient decisions about appropriate health care related to chronic pain. These guidelines are professionally derived recommendations for practices in the diagnosis and treatment of chronic or persistent pain. ⋯ Included in the guidelines is a discussion of their purpose,rationale, importance, and methodology, and patient population, pathophysiologic basis, and various interventional techniques utilized in the management of chronic pain including rationale, outcomes, and cost effectiveness. They also describe the role of diagnostic blocks and therapeutic blocks with suggested algorithms for interventional techniques in the management of conservative care of chronic pain.